tbuckley/cabot-search huggingface dataset:
AB1301 CYCLOPHOSPHAMIDE THERAPY DURING THE COVID19 PANDEMIC
Authors: B. Bitik, C. S. Oygur, A. Yalçintaş Kanbur, A. E. Yucel
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> During the Coronavirus disease (COVID-19) pandemic, one of the biggest concerns of rheumatologists and rheumatology patients has been whether the risk or severity of the disease will increase with immunosuppressive therapy. Some drugs have been reported to be associated with adverse Covid19 outcomes [1,2]. Cyclophosphamide (CYC) is a drug that has been used in rheumatology practice for many years. There is not enough data in the literature on the frequency or consequences of COVID-19 while receiving CYC therapy. <h3>Objectives</h3> The aim of this study is to examine the frequency and outcomes of Covid19 in patients who received CYC therapy during the Covid19 pandemic. <h3>Methods</h3> The files of patients who received CYC therapy protocol between March 2020 and March 2022 at Başkent University Faculty of Medicine Ankara Hospital, Rheumatology outpatient clinic were retrospectively reviewed. In our clinic, CYC therapy is administered as an intravenous treatment protocol of 500 mg three times every 10 days, then 500 mg every two weeks. Although the cumulative dose varies depending on the disease and the patient, it is usually planned to be at least three gram. The diagnosis of Covid 19 was made in the patients with clinically compatible radiology and SARS-CoV-2 PCR test results. <h3>Results</h3> A total of 36 patients received CYC during the specified period. CYC indications were ANCA-associated vasculitis in 12 patients, interstitial lung disease associated with undifferentiated connective tissue disease in 5 patients, SLE in 5 patients, scleroderma in 4 patients, Sjögren's syndrome in 4 patients, Behçet's disease in 1 patient, vasculitis associated with sarcoidosis in 1 patient, rheumatoid vasculitis in 1 patient, leukocytoclastic vasculitis in 1 patient, polymyositis in 1 patient and Takayasu disease in 1 patient.The median age (q1-q3) was 62 (52-68) years. Covid19 infection was detected in only 3 patients (8%) during the CYC therapy protocol. The median cumulative CYC dose for these patients was 3.5 g. One out of 3 patient was hospitalized for Covid 19 pneumonia. There was no death due to Covid19. <h3>Conclusion</h3> In this study, it has been shown that CYC therapy was safe during the Covid19 pandemic period. <h3>References</h3> [1]Samanta J, Naidu G, Deo P, Mittal S, Prasad CB, Das D, Dhir V, Sharma SK, Ramachandran R, Rathi M, Nada R, Minz RW, Jain S, Sharma A. Managing ANCA-associated vasculitis during COVID-19 pandemic: a single-center cross-sectional study. Rheumatol Int. 2022 Dec;42(12):2159-2166. [2]Singh N, Madhira V, Hu C, Olex AL, Bergquist T, Fitzgerald KC, Huling JD, Patel RC, Singh JA. Rituximab is associated with worse COVID-19 outcomes in patients with rheumatoid arthritis: A retrospective, nationally sampled cohort study from the U.S. National COVID Cohort Collaborative (N3C). Semin Arthritis Rheum. 2023 Feb;58:152149. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1485 THE EVALUATION OF THE STATIC AND DYNAMIC BALANCE DISORDERS IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER
Authors: H. E. Konak, S. C. Güven, K. Gok, E. Atalar, O. Küçükşahin, S. Erten
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by self-limiting recurrent episodes/attacks of fever, serositis, arthritis, and erysipelas-like erythema<sup>[1]</sup>. Musculoskeletal manifestations such as arthralgia, enthesitis, exertional leg pain, myalgia, sacroiliitis, and lower extremity synovitis are also common in FMF <sup>[2]</sup>. The fact that the disease progresses with lifelong persistent inflammation, as well as attacks of arthritis, synovitis, and enthesitis in the lower extremities, decreased lower extremity proprioception, muscle weakness, osteopenia, and fatigue, suggests that patients with FMF may develop a balance disorder. <h3>Objectives</h3> The aim of this study is to examine the relationship between static and dynamic balance in patients with Familial Mediterranean fever (FMF). <h3>Methods</h3> FMF patients who met the modified Tel Hashomer criteria and healthy volunteers were included in the study. The demographic data,clinical characteristics, Maastricht Ankylosing Spondylitis Enthesitis Score(MASES) and International Severity Scoring System(ISSF) of FMF patients were evaluated. The balance performance was determined by the Berg Balance Scale(BBS), Functional Reach Test(FRT),Time Up and Go(TUG) tests, and Single Leg Stance(SLS) tests. <h3>Results</h3> When the patient and control groups were compared in terms of BBS, FRT, TUG and SLS tests, scores in the patient group were statistically worse in all evaluations. FMF patients who were at risk of falling were older with longer disease duration(p&lt;0.001 and p&lt;0.001, respectively). VAS scores during attack, presence of arthralgia and amyloidosis were higher in patients at risk of falling(p=0.032, p=0.002, p&lt;0.001, respectively). ISSF and MASES scores of patients at risk of falling were significantly higher than those of patients without(p&gt;0.001 and p=0.001,respectively). <h3>Conclusion</h3> Our results demonstrated that the dynamic and static balance in FMF patients was worse than the healthy subjects. Longer and more severe disease, presence of enthesitis and amyloidosis may further contribute to deteriorated balance. <h3>References</h3> [1]-Chetrit E, Levy M. Familial Mediterranean fever. Lancet (London, England). 1998;351(9103):659-64. [2]Brik R, Shinawi M, Kasinetz L, Gershoni-Baruch R. The musculoskeletal manifestations of familial Mediterranean fever in children genetically diagnosed with the disease. Arthritis and rheumatism. 2001;44(6):1416-9. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1199 PAIN ON WALKING AND PAIN AT REST IN PATIENTS WITH KNEE OSTEOARTHRITIS: IS THERE A DIFFERENCE?
Authors: F. Idrissi Zaki, A. Rafi, A. Mougui, I. El Bouchti
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The knee osteoarthritis (KOA) pain can be divided into two main categories: pain on walking and pain at rest. A thorough understanding of pain is essential for managing KOA. However, few studies have focused on these two types of pain. <h3>Objectives</h3> The objective of this study was to investigate possible factors associated with knee osteoarthritis pain with a focus on the differences between pain on walking and pain at rest. <h3>Methods</h3> Cross-sectional study including 87 patients. All demographic data and visual analog scale (VAS) score at walking, VAS score at rest, Kellgren and Lawrence (KL) stage on radiography, and results of clinical examination were collected. Exclusion criteria were the presence of a total knee prosthesis and patients followed for chronic inflammatory rheumatism. Statistical data analysis was performed using SPSS version 21 software. <h3>Results</h3> This study included 87 patients followed for KOA, with an average age of 63.67+/-5.8 years (46-83 years), and a female predominance (78.3%). In the univariate analyses, significant correlations were found between the VAS score at walking with age (r=0.56, p=0.037), body mass index (BMI) (r=0.61, p=0.023), KL grade (r=0.54, p=0.039) and patellar shock (r=0.46, p=0.044). While the VAS score at rest was only correlated with BMI (r=0.26, p=0.01). And an association between VAS at rest and skin hyperalgesia was noted (p=0.034). The multivariate analysis showed that the significant explanatory factors of the VAS score on walking were BMI &gt; 25kg/m2 (p=0.03) and KL grade &gt;3 (p=0.03). On the other hand, no significant explanatory factor for the VAS score at rest was found. <h3>Conclusion</h3> Predisposing factors were significantly different between the two types of pain, indicating the presence of different pain mechanisms. Pain on walking was more strongly associated with mechanical and structural factors, whereas pain at rest was associated with knee hyperalgesia. <h3>Reference</h3> [1]Satake Y, Izumi M, Aso K, Igarashi Y, Sasaki N, Ikeuchi M. Comparison of Predisposing Factors Between Pain on Walking and Pain at Rest in Patients with Knee Osteoarthritis. JPR. 2021 Apr;Volume 14:1113-8. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1189 BOTULINUM TOXIN TYPE A OR SELECTIVE GENICULAR PULSED RADIOFREQUENCY FOR TREATING ADVANCED KNEE OSTEOARTHRITIS
Authors: M. Hassanien, E. Kamel, R. Gamal, N. Talaat, T. Khedr, A. Alawamy
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Knee osteoarthritis was the most common type (6% of all adults). Developing osteoarthritis increases with age. Pain is a key symptom in the decision to seek medical care and is an important antecedent to disability. <h3>Objectives</h3> To discuss the effectiveness, indications, limitations and side effects of botulinum toxin type A and genicular nerves pulsed radiofrequancy for treating osteoarthritis to help clinicians choose the most appropriate treatment. <h3>Methods</h3> Randomized double blind controlled trial study, <b><i>fifty two participants were recruited divided into 2 groups as follows:</i></b>Group I (Bx): 25 patients given intra-articular botulinum toxin type A 100 IU sonographically guided in patient with osteoarthritis knee according to American Collage of Rheumatology criteria and in stage 3 or 4 of the Kellgren_Lawrence classification Group II (RF): 27 patient get radiofrequncy ablation of genicular nerves. The primery outcome was Visual analogue pain score (VAS), secondry outcome was stiffness, physical function of each knee using Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and Calculation of Oxford knee score at base line, 4,8,12 and 24 weeks. <h3>Results</h3> 16 female and 9 male in group I versus 10 female and 17 male in group II. The mean age were 54.36±7.8 years, there was significant difference in pain VAS between groups at 4<sup>th</sup> week (P value = 0.005). A significant difference in WOMAC pain at 4<sup>th</sup> and 12<sup>th</sup> weeks (P value &gt; 0.001), WOMAC stiffness at 12<sup>th</sup> and 24<sup>th</sup> weeks (P value &gt; 0.001), WOMAC function 4<sup>th</sup>, 12<sup>th</sup> and 24<sup>th</sup> weeks (P value &gt; 0.001) and WOMAC total at 4<sup>th</sup>, 12<sup>th</sup> and 24<sup>th</sup> weeks (P &gt; 0.001).However there were no significant difference in Oxford between the two groups. <h3>Conclusion</h3> Intra-articular Botulinum toxin type A 100 IU can reduce the overall pain and improve the function in Knee osteoarthritis with higher effecacy than Pulsed Radiofrequancy. However. Further research is needed to compare the effect of botulinum toxin type A and Radiofrequancy for the different stages of Osteoarthritis. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1563 CORRELATIONS BETWEEN LUNG INJURY AND PERIPHERAL VASCULAR MANIFESTATIONS IN PATIENTS WITH SYSTEMIC SCLEROSIS: A PRELIMINARY STUDY
Authors: B. Ruaro, E. Baratella, M. Confalonieri, P. Confalonieri, F. Salton
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> systemic sclerosis (SSc) is a rare autoimmune disease characterized by the presence of vascular disease and tissue fibrosis. The alteration of vascular system in SSc is due to dysfunctions of fibroblasts and endothelial cells [1-3]. This dysfunction results in excessive collagen production and vascular damage, which are associated to multiorgan damage. Lung disease in SSc is mainly characterized by interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH). Transthoracic echocardiography is the most commonly used screening tool for PAH in patients with SSc, but definitive diagnosis requires confirmation by right heart catheterization (RHC) [4]. Numerous studies have demonstrated that nail fold videocapillaroscopy (NVC) provides an accurate assessment of microvascular damage in SSc and is able to predict internal organ involvement, such as lung damage. <h3>Objectives</h3> This work aims to evaluate possible correlation between lung injury and peripheral microvascular involvement in SSc patients. <h3>Methods</h3> We enrolled, after obtaining informed consent, 16 patients affected by SSc (classification criteria EULLAR/ACR 2013) (3), who underwent cardiac catheterization for suspicion of PAH (3), in particular we paid attention to the measurement of pulmonary vascular resistance. NVC was performed in all patients, we collected information on the main capillaroscopic alterations such as number of capillaries, megacapillaries, avascular areas and microhemorrhages. <h3>Results</h3> After RHC evaluation, we identified 8 patients with PAH (F/M 6/2; median age 67± 7 SD years) and 8 without PAH (F/M 6/2; median age 66± 8 SD yrs). No significant differences regarding clinical and laboratoristic parameters were observed. At NVC, capillary density was significantly lower in PAH-SSc patients than in SSc patients without PAH (<i>p</i> = 0.04) and avascular areas were more frequent in the first group (<i>p</i> = 0.03). Furthermore, we evaluated a statistically significant correlation between the value of pulmonary vascular resistances at RHC and the number of capillaries at NVC (<i>p</i> = 0.04). We did not observe correlations with the other parameters. <h3>Conclusion</h3> This study confirms the correlation between peripheral microvascular alterations, evaluated by capillaroscopy and the involvement of internal organs, such as pulmonary circulation. Our findings provide additional evidence to the literature data but further studies are underway to confirm these preliminary data. <h3>Reference</h3> [1]Ruaro B et al. Diagnostics (Basel),2022,12:616. 2. Lambrecht V et al. Ann Rheum Dis, 2016,75:1263-1264. 3. van den Hoogen F et al. Ann Rheum Dis, 2013,72:1747-55. 4. Galiè, N et al. The Eur resp j, 2018,53:180-1889. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1268 FIRST DIAGNOSIS OF MONOSODIUM URATE CRYSTAL FROM CEREBROSPINAL FLUID IN PATIENT WITH NECK PAIN
Authors: W. Jeong, J. R. Yoo
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Gout is a common arthritis caused by the deposition of monosodium urate (MSU) crystals within joints after chronic hyperuricemia. Deposition of MSU in the spine as a rare manifestation of gout, but the actual prevalence of spinal involvement is unknown. <h3>Objectives</h3> We present a vertebral osteomyelitis and spinal meningitis misdiagnosed cervical spinal gout. <h3>Results</h3> An 85-year-old man was admitted due to a 5-day history of fever and neck pain. On admission, physical examination revealed neck pain and stiffness. He had a blood pressure of 140/102 mmHg, pulse rate of 95/min, respiration rate of 18 breaths/min, and body temperature of 38.0°C. Laboratory results revealed a white blood cell count (WBC) of 11,200/mm<sup>3</sup> (reference: 4,000–10,000) and C-reactive protein level of 12.26 mg/dL (reference: 0.0–0.3). Magnetic resonance imaging findings suggested cervical osteomyelitis and meningitis (Figure 1A). Cervical spine computed tomography (CT) revealed curvilinear calcifications of the transverse ligament of the atlas (Figure 1B). After assessing blood cultures, an empirical antibiotics were administered intravenously. On the second day of admission, cerebrospinal fluid (CSF) analysis did not reveal meningitis (WBC 8/μL; glucose and protein levels 79 and 168 mg/dL, respectively), and CSF culture and molecular tests were negative for bacteria and mycobacteria. The patient was diagnosed with crowned dens syndrome and administered with 20 mg prednisolone, and his symptoms dramatically improved. However, CSF examination under polarising microscopy revealed monosodium urate (MSU) crystals (Figure 1C), and dual-energy CT confirmed the calcifications to be MSU crystals (Figure 1D). <h3>Conclusion</h3> Crowned dens syndrome is a rare finding in calcium pyrophosphate deposition disease and may be clinically similar to meningitis, so it should be suspected when the evidence for infection is unclear. Our patient had gout history, and MSU crystals were confirmed by CSF analysis and dual-energy CT, suggesting that the symptoms were caused by gout flare in the cervical spine. Thus, physicians should consider that intrathecal MSU crystal formation can cause meningitis-like symptoms in patients with gout history. <h3>References</h3> [1]Michael Toprover, Svetlana Krasnokutsky, Michael H. Pillinger. Gout in the Spine: Imaging, Diagnosis, and Outcomes <i>Curr Rheumatol Rep</i> (2015) 17:70 [2]Jyaysi Desai, Stefanie Steiger, Hans-Joachim Anders Molecular Pathophysiology of Gout <i>Trends Mol Med</i> 2017 Aug;23(8):756-768 [3]Sudoł-Szopińska I, Afonso PD, Jacobson JA, Teh J. Imaging of gout: findings and pitfalls. A pictorial review <i>Acta Reumatol Port</i> 2020 Jan-Mar;45(1):20-25. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1533 DIAGNOSTIC VALUE AND BENEFITS OF PERFORMING A MINIMALLY INVASIVE TECHNIQUE FOR MINOR SALIVARY GLAND BIOPSY, A CASE SERIES
Authors: M. López-Rodríguez, M. Freire, C. Cánovas, A. Andrade, L. Gómez-Suárez, B. Sopeña Perez Arguelles, A. González-Quintela
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Salivary gland biopsy plays an important role in the diagnosis of systemic diseases, especially Sjögren's Syndrome. Minimally invasive biopsy has a low risk of complications with respect to the classical technique, without losing its diagnostic capacity. <h3>Objectives</h3> To assess the utility and safety of minimally invasive technique in patients with suspected systemic disease and salivary gland involvement. <h3>Methods</h3> Retrospective analysis of 31 minor salivary gland biopsies performed by our Systemic Autoimmunity Disease Unit from November 1th 2020 to November 1th 2022, using a minimally invasive technique. Antibody profile and histopathological changes observed were recorded. Adverse events were registered immediately after the procedure and at the next medical visit. <h3>Results</h3> A total of 31 biopsies were reviewed. Mean age of patients was 60 years, most women (n=27, 87%). The success rate of obtaining glandular tissue was 94% (29/31). With respect to immunological data, 24 patients had positive ANAs (77,4%), 24 negative ENAs (77.4%) and 21 negative Rheumatoid Factor (67.7%). In histopathological evaluation 52% were normal salivary tissue (n=16), 23% had focal lymphocytic sialadenitis (n=7), 16% nonspecific chronic sialadenitis (n=5), 6% (n=2) non-existent or insufficient sample and 3% fatty infiltration (n=1). The only complication was a transient superficial lip ecchymosis in one patient (3,2%). <h3>Conclusion</h3> 23% of patients with immunonegative sicca syndrome are diagnosed with Sjögren´s Syndrome due to a minor salivary gland biopsy performed with a minimally invasive technique. This is a simple tool which saves time until diagnosis with low rate complications. <h3>References</h3> [1]Colella G, Cannavale R, Vicidomini A, Itro A. Salivary gland biopsy: a comprehensive review of techniques and related complications. Rheumatology (Oxford). 2010 Nov;49(11):2117-21. doi: 10.1093/rheumatology/keq225. Epub 2010 Jul 25. PMID: 20660500. [2]Teppo H, Revonta M. A follow-up study of minimally invasive lip biopsy in the diagnosis of Sjögren's syndrome. Clin Rheumatol. 2007 Jul;26(7):1099-103. doi: 10.1007/s10067-006-0457-1. Epub 2006 Nov 25. PMID: 17522950. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1207 PREVALENCE OF NEUROPATHIC PAIN AND ITS ASSOCIATION WITH CLINICAL OUTCOMES IN PATIENTS WITH PRIMARY KNEE AND HIP OSTEOARTHRITIS
Authors: D. Santos Oliveira, A. Martins, J. Silveira, F. Neto, L. Costa, C. Vaz, J. Ferreira-Gomes
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Osteoarthritis (OA) is a common musculoskeletal disease associated with significant chronic pain and physical disability. The presence of pain with a neuropathic component may be associated with different phenotypes of this condition. <h3>Objectives</h3> Thus, this study aimed to explore the prevalence of neuropathic pain (NP) and its association with sociodemographic characteristics and clinical outcomes (pain severity and disability), in patients with primary knee and hip OA. <h3>Methods</h3> A cross-sectional study involving adult patients with a primary knee and hip OA diagnosis according to American College of Rheumatology (ACR) was conducted. Sociodemographic variables, symptoms and disease duration and pain characteristics were obtained. Pain severity was assessed with Pain Visual Analog Scale (VAS) and functional disability with Health Assessment Questionnaire (HAQ). Western Ontario and McMaster Universities Arthritis Index (WOMAC) was used to assess pain, stiffness and physical function. The pain DETECT scale was used to evaluate NP in these patients. In order to correlate NP with sociodemographic, clinical and pain characteristics, a correlation coefficient was used- Pearson coefficient. Linear and logistic regression models adjusted for age, gender, symptom duration and diagnosis duration were applied to assess the main predictors of NP. <h3>Results</h3> A total of 36 patients (mean age of 65.1±8.9 years old; 72.2% female) with primary knee OA (n=13, 36.1%), hip OA (n=4, 11.1%) and both (n=19, 52.8%) were included. Patients had a mean symptoms duration of 13.3±8.7 years and a median disease duration of 5 [3-13] years. The mean Pain VAS was 5.0±3.4, and the median HAQ of 1 [0.65-1.91]. The mean of WOMAC- pain, -stiffness, -physical function and -total were 11.9±4.2, 4.5±2.2, 37.5±15.4 and 53.8±20, respectively. Characteristics of NP were found in 28 (77.8%) patients and the mean of PAINDETECT scale was 31.1±11.9. None of the patients had treatment aimed at NP. There were positive correlations between NP and Pain-VAS (r<sub>p</sub> =0.63, p=0.001), HAQ (r<sub>p</sub> =0.33, p=0.005), WOMAC-physical function (r<sub>p</sub> =0.41, p=0.027) and WOMAC-total (r<sub>p</sub> =0.38, p=0.049). In the multivariable model, Pain-VAS predicted NP (β=0.76, p=0.014). <h3>Conclusion</h3> Our study demonstrated that NP is common in patients with OA. The presence of this type of pain is associated with worse clinical outcomes, namely pain severity and functional disability. Hence, these findings encourage the screening of NP in all patients with knee and hip OA in order to implement more appropriated therapeutic strategies. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.